NPI 1205070224

Coyle John Domina, OTRL

Practitioner Occupational Therapist Socorro, NM

Practice location

Address: 700 Franklin St, Socorro, NM 87801-4666
Phone: (505) 306-4475
Mailing address: 11404 Faye Ave NE, Albuquerque, NM 87112-5579

Registered specialties

Occupational Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225X00000X Licence 2566 (NM)

Other Occupational Therapist providers in New Mexico →

Registry record

NPI: 1205070224
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Apr 2009
Record last updated: 21 Apr 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.